Applicant Information

Full Name*

First Middle Initial Last

Date*

Address*

Street Address Apartment/Unit # City State ZIP Code

Phone*

Email*

Date Available*

Desired Salary*

Position Applied For:*

Have you ever worked for this company?*

Yes
No

If yes, when?

Have you ever been convicted of a crime?*

Yes
No

If yes, please explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.

(Any disclosure is not an automatic disqualification for the position)

How did you hear about us? (Please be specific)*

Education

High School*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Did you graduate?

Yes
No

Diploma:

College:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Did you graduate?

Yes
No

Degree:

College:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Did you graduate?

Yes
No

Degree:

Other:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

References

Please list three professional references.

Full Name:*

Relationship:*

Company:*

Email:*

Address*

Street Address City State ZIP Code

Phone*

Full Name:*

Relationship:*

Company:*

Email*

Address*

Street Address City State ZIP Code

Phone*

Full Name:*

Relationship:*

Company:*

Email*

Address*

Street Address City State ZIP Code

Phone*

Previous Employment

Company:*

Phone:*

Address*

Street Address Address Line 2 City State ZIP Code

Supervisor*

Job Title*

Starting Salary:*

Ending Salary:*

Responsibilities*

From*

To:*

Reason for Leaving:*

May we contact your previous supervisor for a reference?*

Yes
No

Company:

Phone:

Address

Street Address Address Line 2 City State ZIP Code

Supervisor

Job Title

Starting Salary:

Ending Salary:

Responsibilities

From

To:

Reason for Leaving:

May we contact your previous supervisor for a reference?

Yes
No

Company:

Phone:

Address

Street Address Address Line 2 City State ZIP Code

Supervisor

Job Title

Starting Salary:

Ending Salary:

Responsibilities

From

To:

Reason for Leaving:

May we contact your previous supervisor for a reference?

Yes
No

Military Service

Branch:

From:

To:

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Signature:*

Date:*

PLEASE READ CAREFULLY

Application Form Waiver

I _______________________ certify that all statements and information contained within this application are true. I understand that the misrepresentation or omission of facts is cause for dismissal at any time without any previous notice. I hereby give Trinity Employment Specialists (TES) permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release TES from any liability as a result of such contact.I also understand that 1) TES has a drug and alcohol policy that provides for pre-employment testing as well as testing after employment; 2) consent to and compliance with such policy is a condition of my employment; and 3) continued employment is based on the successful passing of testing under such policy. I further understand that continued employment may be based on the successful passing of job related examinations.I __________________________________authorize Trinity Employment Specialists and any party or agency contacted to obtain a criminal background check. I understand that any job offers will be contingent on successfully passing both a background check and drug screen.

Signature of Applicant:*

Date*

Trinity Employment Specialists (TES) is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with TES depends solely on your qualifications.

Thank you for completing this application form and your interest in Trinity Employment Specialists.

Emergency Contact Information

Name*

Relationship to you*

Phone Number*

Name*

Relationship to you*

Phone Number*

Trinity Employment Specialists Job Application

Applicant Information

Education

References

Previous Employment

Military Service

Disclaimer and Signature

PLEASE READ CAREFULLY

Application Form Waiver